I was originally meant to be doing the full year of DBT, but due to me passing all my units at uni (yay!) and going on fieldwork next year, I ended up only doing the six months. Which meant I still completed all four modules; mindfulness, interpersonal effectiveness, emotion regulation and distress tolerance, I just won’t be repeating it for the second time round.
I had my last individual DBT therapy session with my psychologist yesterday. When I think about twice when I’ve overdosed/self harmed and ended up in hospital when I had to stop seeing a psychologist, the same when I just thought a psychiatrist was going to stop seeing me, and the rest of the time when I didn’t even properly end with a psychologist, it’s weird not to feel that sense of loss, dread, abandonment and feeling of being ripped apart that I usually feel in ending with a clinician. I guess I just didn’t really feel that sense of connection with her. And it got pretty repetitive and monotonous go go through the same thing every session: diary card, chain analysis, looking at where I could’ve used those DBT skills.
I think I’d feel a much bigger sense of dread and loss when it comes time to be discharged from the mental health clinic and stop seeing my community MH nurse. I was resistant to the idea of seeing a community nurse at the time when I was relapsing with my eating disorder last year, but now that I’ve been seeing her for over a year I’ve come to appreciate being able to just talk to her about whatever’s been going on in my life.
So now that I’ve finished DBT how did I find it? Well perhaps I’m not quite as scathing as I was before starting it. I can see where some of the DBT skills can be helpful when trying to get through a crisis or when trying to deal effectively with other people. At the same time though, I still feel like it doesn’t help me understand myself better on a deeper level and why I feel a certain way then react how I do, and learning the DBT skills doesn’t address if I’m motivated or not to use them in the first place. It’s also quite scary for me that because DBT seems to be regarded as the best damn thing since sliced bread for those who have BPD, now that I’ve completed it, it’s kinda like “Well what now?” So many times when I’ve been in the ED or psych ward, I’ve been told that doing DBT is the solution. Now I’m left wondering “What’s your solution for me now?”
Yesterday afternoon I was seen by the doctors, and my community nurse/case manager also sat in on the meeting. I was asked whether I wanted to be discharged that day or the next, I chose to be discharged that afternoon. Though I still wasn’t great, I at least felt a little better than when I came in and I guess there wasn’t much point in staying any longer. We also discussed my medication, I still remain on 200mg of Pristiq and 50mg of Seroquel XR but have also commenced on 450mg of lithium as a mood stabiliser. It was either lithium or sodium valproate, but according to the doctor the latter has a greater chance of hair loss, weight gain and sedation occurring as side effects.
Spent this morning in tears as I emailed a uni lecturer about something totally unrelated, and in her reply she again brought up an incident last year which resulted in a general miscounduct and me getting into a whole load of trouble. It feels awful that I continue to have that held against me by a lecturer I will again have this semester despite me completing the disciplinary action that was dealt to me and having damn well learnt my lesson. I then attended the last session with my psychologist at the eating disorders program in which I cried some more both talking about this situation with my uni lecturer, and then saying I felt “A bit sad,” when she asked me how I was feeling about it being the last session. It’s the first time I’ve ever admitted to feeling anything other than indifference towards any psychologist I’ve seen as I’ve always been ashamed of feeling attached to or having any emotional connection to others, especially when it’s not reciprocated. Though it wasn’t easy attending knowing it’s my last appointment, I’m glad I did and handled it much better than I did the last time I had to change psychologists. It’s quite embarrassing when I remember how I spent the second last session crying, refused to come back for another session or to see the psychologist I was being transferred to, overdosed and ended up in hospital thus never having a proper concluding session, then wrote him an angry email about how useless therapy is.
I’m starting DBT next week with the group component running on Tuesdays and my first individual therapy session is on Thursday. I’m really nervous about DBT and how full on and strict it seems. At the end of my assessment sessions for DBT I was given a contract and asked to sign it, with rules such as not being allowed to miss a certain number of group or individual sessions, having to complete the homework, rules around interactions with other clients and your therapist not having contact with you for 24 hours if you’ve self harmed. I also have a lot of ambivalence about whether I really do want to change and to stop self harming or not, and so much fear when I think about doing so. Plus I’m hesitant about starting all over again with yet another psychologist knowing that if I do develop a connection it will feel like another loss when we have to cease therapy, especially after weekly appointments for a year.